Table 2

The OSBD: eight behaviour categories7

Category Definition Examples Non-examples
Information seekingAny question regarding medical procedure“When will it stop?”
“Is the needle in?”
“Is the blood coming?”
“Will I get a present?”
CryCrying sound and/or onset of tearsSobbing; booh; crying sounds; tears while they flowSniffling; heavy breathing
ScreamLoud vocal expression at high pitchSharp; shrill; harsh; high tones; shriekLoud yelling but at low pitch
RestraintChild must be physically held down by member of staff or parent
Verbal resistanceAny verbal expression of delay, termination, resistance; must be intelligible“I want to go”
“No more”
“Don't hurt me”
“I don't like this!”
“No, no!”
Emotional supportVerbal or non-verbal; seeking hugs, hand holding; physical or verbal comfort by child“Hold me”
“Help me”
reaching out to be held
“Mummy get me out of here” is VR not ES
Verbal painAny word, phrase or statements referring to pain or discomfort“That hurts”
“It stings”
“Will it hurt?” is IS not VR
FlailRandom, gross movements of arms and legs or whole body; flail in response to restraintPounding fists; kicking legs repeatedly and randomly; flapping of arms on selfMust be random
  • ES, emotional support; IS, information seeking; OSBD, observation scale for behavioural distress; VR, verbal reponse.